And I'm Melissa Block. If there's trouble in Afghanistan, there'll be trouble in Pakistan, too, and vice versa; so the saying goes. Afghanistan is still awaiting results from its election last week, but it's a milestone toward the drawdown of U.S. troops there. Pakistanis worry about whether that will be followed by a spike in Afghan violence that spills over the border. NPR's Philip Reeves reports from Islamabad.

PHILIP REEVES, BYLINE: Doctors in this hospital are at full stretch. Men lie on iron beds beneath whirring fans. They have bleeding and bandaged limbs, and skin pocked by shrapnel wounds. These are the victims of the deadliest attack in Pakistan's capital for more than five years, a bomb in a vegetable market that killed 24 people Wednesday. Ghulam Sarwa, a retired electrician, is visiting a wounded relative. Everyone's on edge, he says.

GHULAM SARWA: (Through interpreter) It creates tension. People get concerned. Poor people get concerned, so it creates a sort of anxiety.

REEVES: Pakistan has long been gripped by anxiety. Now, there are fears there'll be more bloodshed after the drawdown of U.S. forces from Afghanistan. Not long ago, a group of Pakistani politicians and pundits gathered in Islamabad's Marriott hotel. They came to discuss Afghanistan with a visiting NATO delegation.

LEGARI: I don't see any stability in Afghanistan. Is you going from Afghanistan or now? That's your issue. But I want my country to be in peace.

REEVES: Pakistan has not forgotten the Soviet exit from Afghanistan in 1989. The United States used Pakistan as a launching pad to win that final chapter in the Cold War. Pakistanis say the U.S. then walked away, abandoning them in a neighborhood awash with militants, guns and refugees. NATO representative Nicholas Williams told the gathering, no one's walking away this time.

NICHOLAS WILLIAMS: The international community as a whole recognize that as much progress as Afghanistan has made, it still needs help and support beyond 2014.

REEVES: Pakistanis don't have much trust in the international community. Many worry there'll be another civil war in Afghanistan like the 1990s; that the Afghan Taliban and the Pakistani Taliban will join forces, and Pakistan will face even more violence. Mushahid Hussain Sayed chairs the Pakistani Senate's defense committee. He's hopeful history won't repeat itself, but he has concerns.

MUSHAHID HUSSAIN SAYED: If there is no inter-Afghan dialogue, if there is no peace process, if there's a vacuum, that would be disastrous. Its tremors will be felt not just in Islamabad, but they might have a resonance as far away as Europe and North America.

REEVES: The picture's complicated by the role played by Pakistan. Pakistani officials privately acknowledge their intelligence agencies have covertly supported militant groups in Afghanistan, including the Taliban. Rashed Rehman, editor of The Daily Times, says Pakistan's been intervening there for 40 years.

RASHED REHMAN: It still continues. After all, the Taliban, Haqqani network are sitting on Pakistani soil, operating across the border. That's something we like to brush under the carpet and not be reminded of.

REEVES: This impulse to mess with the next-door neighbor is partly driven by Pakistan's anxiety about its old foe, India. The Indians have good relations with Kabul. Pakistanis fear what some call the nutcracker scenario - being caught between two hostile neighbors, India to the east, and a pro-India Afghanistan to the west. Pakistan's government says it's now concluded stability in Afghanistan is crucial for Pakistan, so it won't be interfering anymore.

TARIQ FATEMI: Whatever policy may have been followed in the past, as of now, we shall scrupulously maintain a policy of total noninterference in the domestic affairs.

FATEMI: We have recognized that this policy was harmful to us. It was harmful to the neighbors, and it was harmful to the entire region. We have learned our lessons. We want to stay away from it and instead, we want to reach out.

REEVES: Back in the hospital, electrician Ghulam Sarwa is sure of only one thing.

SARWA: (Speaking foreign language)

REEVES: He says the situation is going to get worse and the Taliban, stronger. Philip Reeves, NPR News, Islamabad. Transcript provided by NPR, Copyright NPR.